Paying to Recline

When it comes to funding for recline systems, says Pride Mobility Products’ Jay Doherty, “As long as it is medically justifiable, most funding sources are funding it these days. It’s a matter of Does the person really have medical necessity for it? It needs to be documented in the doctor’s chart as well as from the therapist because (payors) want those to match, obviously.”

“As a general rule, funding for powered recline is not really different than for powered tilt, as long as the clinical/medical and functional benefits are clearly identified and the supporting physician/therapist evaluation documentation supports the need,” says Invacare Corp.’s Mike Babinec. “The most effective documentation records the individual benefits of the recline and of the tilt, as well as the potential harm if not provided. If requiring the combination of both for the same benefit — i.e., tilt and recline for pressure management — documentation should support this.”

Providers seeking support in their funding quests can look to manufacturers of recline systems. Babinec says, “Many manufacturers of powered seating systems have literature available outlining the applications — clinical & functional benefits of their systems. In addition, RESNA (Rehabilitation Engineering & Assistive Technology Society of North America, resna.org) has published a position paper on the ‘Application of Tilt, Recline& Elevating Legrests for Wheelchairs,’ which outlines these applications as well as provides a list of resources documenting the scientific evidence of these benefits that providers and clinicians alike will find helpful.”

This article originally appeared in the August 2010 issue of Mobility Management.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.